Surgical treatment of primary soft tissue sarcomas involving the chest: Experiences in 25 patients

Background: Primary soft tissue sarcomas of the chest wall are uncommon and data concerning treatment and results are sparse. We reviewed our experience with chest wall resections of these lesions. Methods: Retrospective review of our database identified 25 patients (12 men, 13 women) who underwent chest wall resection for primary soft tissue sarcoma during the 18-year study period (January 1984 through to January 2002). The mean follow-up period was 46.5 months. Results: The 30-day mortality was zero. The cumulative 5-year survival rate of all 25 patients was 56.9%, and the median survival 99.5 months. This compared with 42.2% and a median survival of 36.0 months after chest wall resection for high grade tumor histology. Histological type grading clearly influenced long-term survival (p = 0.036). Local recurrence occurred in 9 patients, 6 of 8 who were resected with positive margins and 3 of 17 who were resected with negative margins. Chest wall resections extended with lung resections did not significantly impair postoperative pulmonary function compared to patients without concomitant lung resections. Conclusions: Chest wall resections in primary soft tissue sarcomas can be accomplished safely with a low mortality rate. Long-term survival can be achieved for primary soft tissue sarcomas but histological grading is of prognostic significance.